For a team that is under 30 years old and mainly from Cairo and despite the amount of researches and statistics we came across, we hoped that there would be some people there who think of FGM as an ancient myth, a tradition that died out many years ago, a television ad that we used to see as kids. It wasn’t until we travelled to Sohag for our first training, sat in a room accommodating more than 20 women from all around Sohag and within a diverse age group to find that there is not a single lady in the room who wasn’t circumcised! We learned that the vast majority of females among those ladies’ own families, are circumcised as well. It was our first time to challenge our own perceptions as a team regarding a highly spread social phenomenon as FGM. According to 2013 UNICEF report, Egypt has the world’s highest total number with 27.2 million women having undergone FGM. These are the types of information that we knew before hand, but dealing with women who had passed through this damaging experience is something different that doesn’t even get easier by studying statistics.
According to the WHO, FGM is classified to three stages; stage 1 is partial or total removal of the clitoris and/or the prepuce, stage 2 indicates partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora, and stage 3 indicates narrowing of the vaginal orifice with creation of a covering seal by cutting and positioning the labia minora and/or the labia majora, with or without excision of the clitoris. The degrees vary as there is no documented process to the operation, neither any kind of training or experience by those who carry it out. Unlike male circumcision, FGM has serious consequences that affect the victim with both short-term and long-term effects. As the WHO puts it: “Female genital mutilation has no known health benefits. On the contrary, it is known to be harmful to girls and women in many ways. First and foremost, it is painful and traumatic. The removal of or damage to healthy, normal genital tissue interferes with the natural functioning of the body and causes several immediate and long-term health consequences. For example, babies born to women who have undergone female genital mutilation suffer a higher rate of neonatal death compared with babies born to women who have not undergone the procedure. Women with FGM have increased risk of stillbirth, infants requiring resuscitation and low birth weight babies. FGM is estimated to lead to extra one or two perinatal deaths per 100 deliveries.”
The biology of this phenomenon is the easiest part to understand and discuss, what is really surprising is what you get from people who believe in it and the various myths behind their stories. We’ve talked to women who pursued their education, even obtained some pre-MA degrees, but still believe they are better off being genitally mutilated because they think it is cleaner, more socially acceptable, more pious this way, and they are willing to do it to their female children as well! Some people think of it is as a religious practice, and hence comes the big debate that always arises when discussing that topic; should we leave religion at the door for the sake of our daughters? Or should we tackle the practice and condemn it from a religious point of view? From our experience on the ground, religion is an integral part of this discussion and should be addressed carefully.
Another debate that we always come to, is whether people do it for religious purposes, or is it just a matter of tribal customs and traditions that are being performed so as to revive the tradition itself without paying much attention to the reasons behind it? After excessive discussions regarding this topic with lots of concerned stakeholders, our team believes it is neither a matter of tradition nor religion; it is rather part of a bigger picture, a picture that includes community passiveness regarding different forms of violence against women.
Different sad stories we heard there. I remember a lady in her late 30s talking about her own experience during one of the trainings and I was shocked when she said she never eaten meat after the day she was cut because she hated the idea of “flesh” taken out of a body, and that she felt as if she was sacrificed! And other young lady who still remembers the details when her daughter’s life was near an end when doing circumcision to her.
Amid these stories we could feel some glimpse of hope when some women assured they will not do such a brutal action to their kids. One lady told us the story how she escaped her husband and his family’s pressure to do it. She left with her daughters away to visit her family and when she went back home she lied to everyone including her husband she did it.
And now, this reshapes the questions that we face now as public health practitioners, governmental sectors or international aid workers. The question now is to whom are we sacrificing the health of our daughters and the future of our society? To thousand-year old traditions? To some claimed extreme religious practices? Or to the lifelong inequality and aggression against women that is present worldwide but takes special forms and shapes in special cultures, and especially in a culture as integrated and mixed as ours? This is an important question that needs to be addressed, but for me what is more important is whether we will just stand-by while we see our children being “sacrificed”, or are we going to join forces to address that traumatizing phenomenon and help eradicating it?